Rutgers New Brunswick/Piscataway Campus
On the Job Injury Form

In the event that you or your staff are involved in an on the job accident, you can obtain the necessary reporting forms from this site.


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If your employee is injured on the job, click on the link below for procedural information.

Required Procedure for employee whom is injured on the job

Supervisors are required to fill out the following forms when reporting an on the job injury or accident:

Employers First Report

Accident Investigation Form


To record unsafe Incidents, please use the form listed below:

Unsafe Incident Form


FMS Safety Program


For questions or comments about this site, contact web master
Last Updated: 12/01/2005

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